第八章 肾脏的排泄功能excretive function of kidney 学习 …_16010.pptVIP

Urinary concentration and dilution Concentrative urine浓缩尿: Osmolality of urine plasma osmolality (300mOsm/L H2O) Diluted urine稀释尿: Osmolality of urine plasma osmolality  Formation of Diluted Urine Isosmotic reabsorption of water at proximal tubule Impermeable of water at thick ascending limb ?ADH? ?Reabsorption of water at distal tubule and collecting duct ? Diluted urine Formation of Concentrative Urine ?ADH? ? Reabsorption of water at distal tubule and collecting duct ? Concentrative Urine ADHkey element of urinary concentration and dilution The Osmotic Gradient of the Renal Medulla Formation of Osmotic Gradient of the Renal Medulla Permeability of the Tubular System Formation of Osmotic Gradient of the Renal Medulla The countercurrent theory 1. Countercurrent multiplication逆流倍增 Establishing of Osmotic Gradient of the Renal Medulla The Countercurrent Theory 2. Countercurrent exchange 逆流交换 Maintenance of the Osmotic Gradient in the Medulla The vasa recta: Countercurrent exchanger Summary:Formation of Concentrated or Dilute Urine In the presence of ADH Collecting duct permeable to water ? excretion of a concentrated urine In the absence of ADH Collecting duct impermeable to water ? excretion of a diluted urine Factors that affect the concentration and dilution of the urine 1) Damage of renal medulla Resulting in an impairment of the concentrating ability 2) Loop diuretics such as frusemide, inhibiting the Na+/ K+/ 2Cl- co-transport system in the thick ascending limb Factors that affect the concentration and dilution of the urine 3) Lack of urea in the body such as malnutrition, reducing the osmotic gradient established in the renal medulla 4) Increased velocity of blood flow in the vasa recta carrying away amount of NaCl ? reducing the osmotic gradient in the medulla Humoral Control of Renal Functions Antidiuretic hormone (抗利尿激素，ADH) Synthesis in supraoptic and paraventricular nuclei（视上核与室旁核） Release from t